Abstract
Objective: To assess the value of laparoscopic evaluation of the pelvis after failure to achieve pregnancy with clomiphene citrate-induced ovulation and to determine whether predictors for significant pelvic pathology can be isolated. Design: Retrospective study. Setting: Tertiary care academic medical center. Patient(s): Ninety-two patients failing to conceive after four ovulatory cycles with clomiphene citrate with a normal hysterosalpingogram who underwent laparoscopic evaluation of the pelvis. Intervention(s): Laparoscopy. Main Outcome Measure(s): Presence of pelvic pathology and predictors of pelvic disease. Result(s): Of the 92 patients studied, 32 patients (34.8%) had a "positive" laparoscopy (i.e., stages III and IV endometriosis, an endometrioma, pelvic adhesions, and/or tubal disease), 27 patients (29.3%) had stage I or II endometriosis, and 30 patients (32.6%) had a normal pelvis. The predictors for intrapelvic disease were a history of dyspareunia, no prior use of oral contraceptive pills, and no prior use of any form of contraception. Almost 40% of women with predictors had a "positive" laparoscopy, compared with only 12.5% of patients without predictors; however, the majority of patients (91.3%) had at least one predictor. Conclusion(s): More than one third of the patients failing to conceive after four ovulatory cycles of clomiphene citrate had significant intrapelvic pathology. Although predictors for intrapelvic disease were isolated, their high prevalence reduced their predictive value.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1450-1453 |
| Number of pages | 4 |
| Journal | Fertility and Sterility |
| Volume | 80 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jan 1 2003 |
Fingerprint
Keywords
- Clomiphene citrate
- Infertility
- Intrapelvic disease
- Laparoscopic evaluation of pelvis
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynecology
Cite this
Laparoscopic evaluation following failure to achieve pregnancy after ovulation induction with clomiphene citrate. / Capelo, Frank Ochoa; Kumar, Ashim; Steinkampf, Michael P.; Azziz, Ricardo.
In: Fertility and Sterility, Vol. 80, No. 6, 01.01.2003, p. 1450-1453.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Laparoscopic evaluation following failure to achieve pregnancy after ovulation induction with clomiphene citrate
AU - Capelo, Frank Ochoa
AU - Kumar, Ashim
AU - Steinkampf, Michael P.
AU - Azziz, Ricardo
PY - 2003/1/1
Y1 - 2003/1/1
N2 - Objective: To assess the value of laparoscopic evaluation of the pelvis after failure to achieve pregnancy with clomiphene citrate-induced ovulation and to determine whether predictors for significant pelvic pathology can be isolated. Design: Retrospective study. Setting: Tertiary care academic medical center. Patient(s): Ninety-two patients failing to conceive after four ovulatory cycles with clomiphene citrate with a normal hysterosalpingogram who underwent laparoscopic evaluation of the pelvis. Intervention(s): Laparoscopy. Main Outcome Measure(s): Presence of pelvic pathology and predictors of pelvic disease. Result(s): Of the 92 patients studied, 32 patients (34.8%) had a "positive" laparoscopy (i.e., stages III and IV endometriosis, an endometrioma, pelvic adhesions, and/or tubal disease), 27 patients (29.3%) had stage I or II endometriosis, and 30 patients (32.6%) had a normal pelvis. The predictors for intrapelvic disease were a history of dyspareunia, no prior use of oral contraceptive pills, and no prior use of any form of contraception. Almost 40% of women with predictors had a "positive" laparoscopy, compared with only 12.5% of patients without predictors; however, the majority of patients (91.3%) had at least one predictor. Conclusion(s): More than one third of the patients failing to conceive after four ovulatory cycles of clomiphene citrate had significant intrapelvic pathology. Although predictors for intrapelvic disease were isolated, their high prevalence reduced their predictive value.
AB - Objective: To assess the value of laparoscopic evaluation of the pelvis after failure to achieve pregnancy with clomiphene citrate-induced ovulation and to determine whether predictors for significant pelvic pathology can be isolated. Design: Retrospective study. Setting: Tertiary care academic medical center. Patient(s): Ninety-two patients failing to conceive after four ovulatory cycles with clomiphene citrate with a normal hysterosalpingogram who underwent laparoscopic evaluation of the pelvis. Intervention(s): Laparoscopy. Main Outcome Measure(s): Presence of pelvic pathology and predictors of pelvic disease. Result(s): Of the 92 patients studied, 32 patients (34.8%) had a "positive" laparoscopy (i.e., stages III and IV endometriosis, an endometrioma, pelvic adhesions, and/or tubal disease), 27 patients (29.3%) had stage I or II endometriosis, and 30 patients (32.6%) had a normal pelvis. The predictors for intrapelvic disease were a history of dyspareunia, no prior use of oral contraceptive pills, and no prior use of any form of contraception. Almost 40% of women with predictors had a "positive" laparoscopy, compared with only 12.5% of patients without predictors; however, the majority of patients (91.3%) had at least one predictor. Conclusion(s): More than one third of the patients failing to conceive after four ovulatory cycles of clomiphene citrate had significant intrapelvic pathology. Although predictors for intrapelvic disease were isolated, their high prevalence reduced their predictive value.
KW - Clomiphene citrate
KW - Infertility
KW - Intrapelvic disease
KW - Laparoscopic evaluation of pelvis
UR - http://www.scopus.com/inward/record.url?scp=0348110636&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0348110636&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2003.05.012
DO - 10.1016/j.fertnstert.2003.05.012
M3 - Article
C2 - 14667882
AN - SCOPUS:0348110636
VL - 80
SP - 1450
EP - 1453
JO - Fertility and Sterility
JF - Fertility and Sterility
SN - 0015-0282
IS - 6
ER -